CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St David's Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $225
  • Cash Discount Price: $554
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St David's Medical Center is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $554. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.01x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$554

Average discount available for prompt cash payment at this facility.

Insurance Median
$225

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$223.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $223.72 (100%)
Cash / Self-Pay: $554 (248%)
Insurance Median: $225 (101%)
Cash: $554 (248% of Medicare)
Ins. Median: $225 (101% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $223.72 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Amerigroup $12 5%
Superior Health Plan $22 - $119 10%
Oscar $83 - $150 37%
Moda $102 - $165 46%
United $108 - $316 48%
Covenant Management Systems $125 - $202 56%
Healthcare Highways $126 - $211 56%
Imo Med - Select Network $130 - $211 58%
Blue Cross Blue Shield $138 - $1,058 62%
Cigna $139 - $288 62%
Moda Health $156 - $260 70%
Texas Healthcare Foundation Heb $160 - $260 72%
Texas Workforce Commission $169 - $274 76%
Averde Health $195 - $316 87%
Comanche County $216 - $351 97%
National Choicecare $216 - $351 97%
Healthsmart Preferred Care $238 - $562 106%
Independent Medical Systems $238 - $386 106%
Physicians Cooperative Of Texas $238 - $386 106%
Prime Health $260 - $421 116%
First Health $273 - $505 122%
Coastal Comp Health Networks $281 - $456 126%
National Health Care $281 - $456 126%
Occunet $303 - $491 135%
Texas Municipal League $303 - $491 135%
Medcorp Southwest $325 - $526 145%
Rockport Healthcare Group $346 - $632 155%
Bce Emergis Corporation $390 - $632 174%
Beech Street $390 - $632 174%
Medical Control Network Solutions $390 - $632 174%
Multiplan $390 - $632 174%
Aetna $7,657 - $12,950 3423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals